CRYOTHERAPY

OBJECTIVES

By the end of this lecture the students will be able to identify & explain

• The concept of cryotherapy

• methods
• Physiological effects
• Indications & contraindications
DEFINITION

• Cryotherapy is the local or general use of

low temperatures in medical therapy or
the removal of heat from a body part.

• Cold therapy is one of the most popular

methods when it comes to the first aid
treatment of some injuries.
CRYOTHERAPY FACTS

• Nowadays, local cold application may be applied by the use of various forms of ice or
frozen gel packs,

• Often skin temperature is reduced to 10 C°.

 PRINCIPLE

When ice is applied to the skin heat is conducted from the skin to the ice in order to melt it.

• The ice requires considerable energy to rise the temperature of 1 g of ice at 0°C to 1 g of water at 37°C
requires 491 J.
• Whereas to rise 1 g of water at 0°C to 37°C requires only 115J.

Consequently when trying to cool tissues it is important to use ice during treatment and not just cold water.
 METHODS OF APPLICATION
• The way which ice is applied will vary according to the required effects.
• It may be applied in the following ways:

• Ice Packs/ Commercial Cold packs

• Immersion
• Ice cube massage
• Ice spray
ICE PACKS

• There are many kinds of chemical cold packs available for first aid kits, To make an ice pack with
items from home, you'll need:
• ice
• a sealable plastic bag
• a towel or pillow case
• Never place ice directly on skin. Ice can cause frostbite if left on skin for very long. Wet towel
should be placed between the skin and the pack to avoid excessive cooling.
• Regardless what you put between the ice and the victim's skin, do not leave the ice on the skin
longer than 20 minutes
ICE PACK-AT HOME
COMMERCIAL COLD PACKS
IMMERSION

• Immersion involves placing the part to be

treated in water ranging in temperature
from cool to icy.
• Appropriate for treatment of an extremity
or large body areas.
• Cold water immersion is ideally used
following a heavy weights session,
between training sessions or after muscle
injury resulting in soreness or bruising.
IMMERSION

Example
• 1 minute plunge- (try to relax as much as possible),
• 2 minutes out of water (air temperature) ,
• Repeat 5 times.
• When very brave, 5 minutes straight
ICE CUBE MASSAGE

Used for two distinct reasons

• counter-irritant action
For the relive of pain ice block is moved over the part using a slow circular massage.
• Muscle stimulation
For neurological facilitation the ice should be applied only briefly.
 EVAPORATING SPRAYS

• Spraying a rapidly evaporating liquid on the skin has the effects

of cooling the surface.
• The liquid is sprayed on to the area to be cooled in a series of
short strokes of 5 s each.
• The nozzle of the spray is held about 45 cm from the skin.
• Cooling from such sprays not lasts very long.
PHYSIOLOGICAL EFFECTS OF COLD APPLICATION

Circulatory
Response

Excitatory
Neural
Cold
response
Mechanism
EXCITATORY COLD MECHANISM

• When cold is applied in an appropriate way on the skin, it increase the excitatory bias
around the anterior horn cell.
• This can often produce contraction of an inhibited muscle (only with intact peripheral
nerve supply).
• This effect can be used when muscle are inhibited postoperatively or in the later stages of
regeneration of a mixed peripheral nerve.
 CIRCULATORY RESPONSE

• The initial skin reaction to cooling is an attempt to preserve

heat. It is accomplished by an initial vasoconstriction. This
haemostatic response has the effect of cooling of the body
part.
• After a short period of time vasodilatation follows with
alternating periods of constriction and dilatation this is
called the “Lewis’s Hunting Reaction”.
• During the vasodilatation, the arteriovenous anastomosis
NT release is closed, thus causing an increase blood flow
through the capillaries. This is beneficial in the treatment of
swelling and tissue damage
NEURAL RESPONSE

• The skin contains primary thermal receptors.

• Cold receptors are several times more numerous than warm receptors.
• The rate of conduction of nerve fibers in a mixed peripheral nerve is reduced by cooling.

• Cold therapy machines can cause permanent nerve damage (also known as “peripheral
neuropathy”) as a complication of cold injuries like frostbite and skin necrosis. These
injuries occur when patients use the machines for several hours of “continuous cold
therapy” without checking their skin for symptoms of nerve damage.
SYMPTOMS OF NERVE DAMAGE

• Tingling and burning sensation

• Deep pain
• Numbness (loss of feeling in arms and legs)
• Muscle weakness
• Loss of fine motor coordination
• Skin discoloration, redness, swelling, or hardness
• Cold sensitivity

So check your skin every 20-30 mins for symptoms of nerve damage from cold therapy.
INDICATIONS

Provide Promote
excitatory repair of
Muscle Spasticity
Pain stimulus to the
spasm. Swelling. . inhibited damaged
muscles. tissues.
CONTRAINDICATIONS

Peripheral
Altered skin Cardiac Raynaud’s Peripheral Cold
Vascular
sensation Conditions disease Nerve Injuries Sensitivity
Disease
 Presentation Title | Presented By: Name 03/02/2024

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